What you need to know about micronutrients and dietary supplements in Africa

Micronutrients are chemicals or substances required in small or trace amounts by the body for growth and  maintenance of a healthy living organism. Common micronutrients required by every man, woman and child include vitamins like vitamin A, B, C, D, E and folic acid; a host dietary minerals like iron, zinc, copper, chlorine, sodium, manganese, cobalt, molybdenum, and many others and water.

The best way to provide your body with all the vital micronutrients is through proper diet. But sometime due to lifestyle or a multitude of other factors, the body doesn't get enough micronutrients needed to keep itself healthy and thrive. In such scenarios, dietary supplements can be very beneficial. Dietary supplements exist in various forms as vitamins, minerals, amino acid, enzyme and many other products. They are available in a variety of forms at stores, such as tablets, capsules, powders, drinks, energy bars and syrups. Some of the most popular supplements include Vitamin A, B, C, D and E, minerals like calcium and iron, and other specialty products such as probiotics and fish oil.

In most countries of Sub-Saharan Africa, micronutrient deficiencies are common and of wide public health concerns. For this reason, one of the best approaches to tackling this public health challenge is through population level micronutrient supplementation. At the individual level and no matter where you live worldwide, dietary supplements are effective ways to provide your body with all the nutrients that your diet isn't able to provide in sufficient quantity. Supplements are beneficial to health, but they also have health risks. 

Who needs dietary supplements?

Nutritional or dietary supplements are not substitutes for a balanced healthy diet.  An African consuming enough fruits, vegetables, whole grains, adequate amount of protein and healthy fats daily, will probably get all the micronutrients needed to stay healthy. Dietary supplements should only be taken in those cases when despite taking healthy diet, your body doesn't get all the nutrition it needs. Here are some situations when an individual should consider dietary supplements:

  • Vitamin or mineral deficiencies - When your doctor or a health care practitioner finds out through blood test that your body lacks important vitamins and minerals, they may recommend dietary supplements. In such case, taking dietary supplement will correct the deficiency. 

  • Inadequate diet - If for any reason your diet is not capable of providing all the nutrients, for example you take vegan diet or because of cost, lack of availability or your health condition, certain foods are restricted, your body may miss out on some important vitamins and minerals. In such case certain supplements may help your body.

  • Pregnant women - Some nutrients are important for pregnant women as they prevent birth defects and encourage good health of the mother and baby in the womb. If you are planning to conceive, you should consult your doctor or nurse about pre-pregnancy and pregnancy supplements. 

  • Aging -  As we age our body undergoes certain changes. The amount of food your body needs also reduces and so does your appetite and ability to absorb ingested foods. Minerals and vitamins requirements also change. Infact, our body will need more vitamins and minerals as it grows old. It will require appropriate supplements to makeup the deficit. 

  • Unable to absorb certain nutrients - Due to medical conditions, the body may not be able to absorb certain essential nutrients (a condition referred to as “malabsorption” in medical jargon). For example some kind of bowel (gastrointestinal or GI) diseases and surgeries like bariatric surgery impacts the body’s ability to absorb certain essential nutrients. In these specific situations, your doctor will recommend taking certain supplements. 

  • Medications - Certain medications lead to deficiencies. For example proton pump inhibitors for acid reflux is known to cause vitamin B12 deficiency. 

Health risks associated with not getting enough nutrients

Due to modern lifestyle, not everyone is able to get enough of essential nutrients and minerals. Some of the most common nutrient deficiencies in Africa include vitamin A, vitamin C, vitamin D, iron, folic acid, calcium, and iodine. 

Studies have found that certain age groups are more likely to experience several essential minerals deficiencies. In Africa for example, iron deficiency is more common in teenage girls than teenage boys or people from other age groups. Iron deficiency in young African women is the most common reason for low-birth weight infants. Iron deficiency also leads to delayed brain development in children. Folate is another nutrient that is extremely important for pregnant women. Obstetrician/gynecologist recommend folic acid before conception and advise to continue it for the first 12 weeks of pregnancy. Folate deficiency increases the risk of baby developing neural tube defects such as spina bifida. 

Vitamin A deficiency (VAD) and iodine deficiency (ID) are also common and usually coexist especially in young school aged African children and African women of reproductive age.  

Vitamin A deficiency causes dry skin, dry eyes, night blindness, increased frequency of throat and chest infections, delayed growth, poor wound healing and fertility problems in both men and women. Iodine deficiency causes swelling in front of neck due to goitre (thyroid gland enlargement), unexpected weight gain, fatigue and weakness, hair loss and dry flaky skin, slow heart rate, learning and memory problems and more.

Happily, the consequences of VAD and ID can be readily corrected with appropriate supplements of vitamin A and iodine in daily diet.    

Important dietary supplements

Specific population group based on age, gender or lifestyle, may require certain minerals and vitamins more than other people (see table below). If you belong to any of the below group, you should consult your doctor to find out whether your body needs supplements or not.

People with a good appetite who include a wide variety of food in their diet, may not need any supplement.

Health risk associated with supplements

Well balanced diet is the best way to provide your body with all the vital nutrients and minerals. If you are taking supplements, just know that your diet already contains some vitamins and minerals. Some of the vitamins and minerals are already present in maximum intake levels in your existing diet, specially fortified foods and beverages. Many of these vitamins and minerals are required in only small or moderate amounts by your body. Taking them more can cause toxic symptoms, known as hypervitaminosis. 

Selenium is a mineral that is required by your body in a very small amount. But if your body gets too much of it, it adversely impacts the central nervous system. Vitamin A is an essential nutrient. But too much of it can lead to nausea, headache, visual changes, dry rough skin, mouth sores and confusion. Hypervitaminosis (or excessive vitamin levels in the body) is usually associated with fat-soluble vitamins because it is not easy for the body to get rid of it. 

To avoid any health risk associated with drugs and supplements, you should be mindful and consider the vitamins and minerals your body is getting from all the sources including your diet. You should only take enough supplements to cover any perceived or laboratory identified shortfall in your total intake of essential nutrients for each day. If you are not sure which supplement to take and in what quantity, you should consult your doctor or a nutritionist. Infact, you should consult a doctor to determine whether your body needs additional supplement. If because of health condition, medication or other reason, your doctor has recommended taking certain supplements, you should not miss them or take them in excess of your doctor’s recommendation. 

 

Additional resources:

World Health Organisation: Micronutrient deficiencies:

 

Published: November 4, 2019
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